Medicare Corner 2

Posted By Cindy Lee on Aug 2, 2017

July 31, 2017

Dear Medicare Counselor,

Q: I am turning 65 in three months and I become Medicare eligible the first of the month that I turn 65. I am still working and I have health insurance through my company. Do I need to enroll into Medicare?

A: No. IF you are covered by an Employer Group Health Plan (EGHP) through your current active employment or your spouse’s active employment, you may stay with your group plan. You do not need to take Medicare at this time, unless your company plan requires it (e.g. less than 20 employees). If you have worked for 10 years or 40 quarters and this work has paid into Social Security, you are entitled to Medicare Part A Hospital Insurance without further cost. Most people go ahead and sign up for Part A coverage (although other rules apply if you have a Health Savings Account with a High Deductible Health Plan).

Part B Medical Insurance has a monthly premium cost. If you have active employment coverage (NOT retiree nor COBRA nor VA benefits, none of which will exempt you), you may delay the start of your Part B coverage without penalty. You do not need to take Part B at this time. In fact, you may wish NOT to take Medicare Part B at this time and preserve for later all your enrollment guaranteed rights. Different Medicare rules apply for Part D drug coverage.

If you are already receiving your Social Security benefits, you will automatically be enrolled into Medicare Parts A and B, and you will be sent a Medicare card. In this case, you would need to decline Part B if you do not wish to have Part B coverage start on your eligibility date with those premiums deducted from your Social Security benefit.

To be eligible to enroll later for Medicare Part B Medical Insurance with no penalty and no delay, during what is called a Special Enrollment Period, a beneficiary must be covered under their employer’s or spouse’s employer’s group health plan beginning the first month of Part B eligibility based on age, which is the month of turning 65 or the prior month if born on the 1^st of the month. Social Security policy reference is provided:

https://secure.ssa.gov/apps10/poms.nsf/lnx/0600805270

When you choose to retire or lose coverage from your or your spouse’s active employment plan, you will need to submit forms to Social Security to apply for Medicare and to demonstrate that you are eligible for the Special Enrollment Period, without a late enrollment penalty or enrollment delay.

Request for Employment Information

https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf

Application for Medicare Part B Enrollment

https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS40B-E.pdf

A gentleman who was becoming Medicare eligible once called our office and exclaimed in dismay: “I AM a rocket scientist, and I don’t understand any of this!”

Just know that you may see or speak with a trained staff or volunteer counselor who can provide information, education and assistance to help navigate the Medicare maze. It’s complicated. You are not alone, and we’re here to help!

* * * * * *

For more information, assistance or an in-depth explanation of your Medicare benefits, call the State Health Insurance Assistance Program (SHIP) office for free advice from a trained Medicare Counselor. SHIP is a national network, local community service that is provided to every county in the U.S. There is no insurance company affiliation or sales.

Your local State Health Insurance Assistance Program (SHIP) office can help you determine the best way to maximize access to your health care and Medicare benefits.

In Maricopa County, call the Benefits Assistance Program at the Area Agency on Aging: (602) 280-1059
BAP SHIP PROGRAM Video 2 mins

One-on-one free Medicare counseling is available through the SHIP Program by phone or in person from a Benefits counselor at the Area Agency on Aging: (602) 280-1059

You may submit a question to Medicare Corner through “Submit a Comment” below for a reply in the next issue. All questions are not certain to be posted and answered in the magazine.

Website: Benefits Assistance Program – Medicare

The Peak Welcomes Your Comment

The Peak invites you to share your thoughts about this article by using the “Submit a Comment” box at the bottom of this page. All comments are reviewed based on The Peak’s Comment Policy prior to publishing.

GPPA Membership Make a Donation to GPPA Peak Advertisements & Advertorials